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Chronic paranasal sinusitis exacerbates allergic inflammation in patients with asthma and contributes to refractoriness to treatment

Mayuko Tanaka, Takenori Okada, Hiroyoshi Watanabe, Hideyuki Satoh, Shingo Tokita, Tomoshige Wakayama, Kenya Kohyama, Naoto Fueki, Hironori Sagara
European Respiratory Journal 2012 40: P2350; DOI:
Mayuko Tanaka
1Department of Respiratory Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
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Takenori Okada
1Department of Respiratory Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
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Hiroyoshi Watanabe
1Department of Respiratory Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
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Hideyuki Satoh
1Department of Respiratory Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
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Shingo Tokita
1Department of Respiratory Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
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Tomoshige Wakayama
1Department of Respiratory Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
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Kenya Kohyama
1Department of Respiratory Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
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Naoto Fueki
1Department of Respiratory Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
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Hironori Sagara
1Department of Respiratory Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
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Abstract

Background: Factors such as airway inflammation, airway hyperresponsiveness, and airway remodeling contribute to the pathogenesis of refractory asthma in a complex fashion. Many studies have reported the development of severe disease in patients with asthma associated with allergic rhinitis. However, the relation between chronic paranasal sinusitis and severe asthma remains largely uninvestigated. In the present study, we examined whether the concurrent presence of paranasal sinusitis contributes to the development of refractory asthma.

Subjects: Three groups of patients were studied: those with asthma, those with chronic paranasal sinusitis, and those with both asthma and paranasal sinusitis. Peripheral eosinophil counts, serum IgE levels, exhaled nitric oxide (FeNo) levels as a maker of airway inflammation, and airway hyperresponsiveness were compared among the groups.

Results: Peripheral eosinophil counts, FeNo levels, and serum IgE levels were higher in patients with asthma and chronic paranasal sinusitis than in patients with asthma alone and patients with chronic paranasal sinusitis alone. Airway hyperresponsiveness was slightly increased in patients with chronic paranasal sinusitis, but was further increased in patients with asthma, and was significantly increased in patients with asthma plus chronic paranasal sinusitis.

Conclusions: Our results suggest that chronic paranasal sinusitis may modify airway inflammation in patients with asthma and contribute to the exacerbation of disease. Paranasal sinusitis should thus be adequately treated in patients with asthma complicated by chronic paranasal sinusitis.

  • Asthma - management
  • Inflammation
  • Asthma - mechanism
  • © 2012 ERS
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Chronic paranasal sinusitis exacerbates allergic inflammation in patients with asthma and contributes to refractoriness to treatment
Mayuko Tanaka, Takenori Okada, Hiroyoshi Watanabe, Hideyuki Satoh, Shingo Tokita, Tomoshige Wakayama, Kenya Kohyama, Naoto Fueki, Hironori Sagara
European Respiratory Journal Sep 2012, 40 (Suppl 56) P2350;

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Chronic paranasal sinusitis exacerbates allergic inflammation in patients with asthma and contributes to refractoriness to treatment
Mayuko Tanaka, Takenori Okada, Hiroyoshi Watanabe, Hideyuki Satoh, Shingo Tokita, Tomoshige Wakayama, Kenya Kohyama, Naoto Fueki, Hironori Sagara
European Respiratory Journal Sep 2012, 40 (Suppl 56) P2350;
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